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COVERED: a week-by-week look at the political and legislative developments that led to the creation of Medicare and Medicaid 50 years ago. Bob Rosenblatt, Academy senior fellow and former Los Angeles Times Washington correspondent will report on the people and the maneuvers that led to this major expansion of social insurance.

Project Update: NASI Study Panel on Pricing Power Announces Forthcoming Papers on State Laws, Integrated Delivery Networks, and a Symposium on Antitrust Policy in Health Care

For Immediate Release:May 12, 2014

Contact: Jill Braunstein at (202) 452-8097

WASHINGTON, D.C. – The National Academy of Social Insurance’s (NASI) study panel on pricing power in health care markets announced a series of papers and an antitrust symposium that will address gaps in knowledge on this vital issue. The 17-member study panel has been tasked with evaluating the range of market-oriented and regulatory policy options addressing the market power of health care providers and purchasers. A final report, expected in the Fall, will explore the advantages and disadvantages of various policy options. (For details on the project see Study Panel Announced for NASI Project to Address Pricing Power in Health Care Markets.)

The study panel, co-chaired by Robert A. Berenson, M.D., of the Urban Institute and G. William Hoagland of the Bipartisan Policy Center, commissioned the following papers to be published in the Summer of 2014:

State laws aimed at improving the competitiveness of health care markets primarily by limiting the use of certain anti-competitive contracting practices, by Suzanne Delbanco and Shaudi Bazzaz of the Catalyst for Payment Reform, and Vishaal Pegany of the Goldman School of Public Policy at the University of California, Berkeley. The paper will cover prohibitions such as “most favored nations” clauses, gag clauses that forbid disclosure of pricing information, anti-tiering clauses, and “all or none” contracting for multi-hospital systems, and will highlight innovative state actions.

Integrated delivery networks(IDNs) will investigate vertical integration and what is known from publicly available data about the performance of large health systems. Authored by Jeff Goldsmith of Health Futures, Inc. and L. Robert Burns of the University of Pennsylvania, the paper will establish a baseline for what can be determined about IDNs from public data, and raise a host of questions about what data is needed to further assess their financial and performance efficiencies.

​The half-day symposium, Can Antitrust Policy Address Pricing Power in Health Care Markets? on May 29th in Washington, DC will feature panels on the utility of antitrust law to counter the pricing power of physicians and hospitals and the implications of public and private-sector Accountable Care Organizations for competitive markets. Participants will address the ability of antitrust law to both prevent the development of uncompetitive markets and to offer effective remedies in the case of past consolidations by either hospitals, physicians or other providers. The event is free and open to the public.

"Together, the symposium and the papers are an example of how NASI is working to advance understanding of the key issues policymakers face when they consider pricing power in the health care markets,” said Pamela Larson, Executive Vice President of NASI. “These papers will dive deeply into issues confronting the study panel. In some cases, they highlight where our current knowledge and policies fall short.”

Support for this project is provided by the Robert Wood Johnson Foundation and The California HealthCare Foundation, based in Oakland, California, and the Jayne Koskinas and Ted Giovanis Foundation for Health and Policy.

The National Academy of Social Insurance is a non-profit, nonpartisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.